Among black people, primary open-angle glaucoma is a major cause of irreversible blindness that is avoidable with early detection and treatment. This paper presents an account of a qualitative investigation, based on a phenomenological approach, into glaucoma awareness based on semi-structured interviews and focus groups with 48 African-Caribbean participants who were not receiving treatment from a hospital eye service. Data were analysed using manual and computerised methods to identify six themes: 'knowledge of glaucoma', 'glaucoma risk perception and heuristics', 'images of blindness', 'health accounts', 'glaucoma risk perception' and protection motivation theory and 'cultural context and individual differences'. Findings showed that while participants held positive attitudes to health promotion in general, these did not incorporate eye health. Factors such as family histories, where available, were very important in helping individuals to understand that glaucoma might affect them, and in what ways this might happen. Attitudes to blindness tended to reflect the notion of the blind person as a victim. The idea of taking action to prevent this happening hinged upon participants' perceptions of the credibility of both the source and the nature of the information they had received about glaucoma. It is anticipated that this study will help practitioners to understand the health beliefs of African-Caribbean patients with this condition and to assist in recruitment to further research on glaucoma pathogenesis and clinical outcomes in the African-Caribbean eye.

The inter-relationship between health-care research, policy and service development is convoluted and difficult to articulate. This paper describes a framework for planning research into a range of ophthalmic conditions differentially associated with specific ethnic groups. It discusses the utility of the 'Shah-Cross Model' in mapping development of a glaucoma research project, and communicating its implications for local eye-care policy and ophthalmic services directed towards detection and management of primary open-angle glaucoma in the African-Caribbean population in the UK.

Investigations into glaucoma awareness have drawn on informed, clinic-based populations. The paper reports a section of findings from a larger study that aimed to elicit the perceptions of those potentially less informed in community settings.MethodsA qualitative investigation used face-to-face interviews and focus group discussions with 48 African Caribbean participants outside the hospital eye-service. Interview data were transcribed and coded using manual and computer-aided methods. Inferences and interpretations were corroborated by discussion with expert advisors and community members not directly involved in the study.ResultsPositive attitudes to health promotion existed, but 'eye health' did not appear to be integral to individuals' health schemas. The capacity for primary eye care to enhance glaucoma knowledge appeared under utilised and inconsistent across modes of service delivery and was undermined by perceived conflicts of interest.ConclusionsEnhancing reciprocal understanding between service users and ophthalmic practitioners in primary care is central to developing flexible, responsive local eye-care services. The study suggested useful foci for cultural self-reflection and self-awareness on the part of health professionals themselves, in relation to glaucoma detection. Areas for further research are identified.Eye advance online publication, 11 August 2006; doi:10.1038/sj.eye.6702461.

Export search results

The export option will allow you to export the current search results of the entered query to a file. Different
formats are available for download. To export the items, click on the button corresponding with the preferred download format.

By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export.
The amount of items that can be exported at once is similarly restricted as the full export.

After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.